Decision Date: 1995-07-14 Archive Date:
07/21/95
DOCKET NO. 93-19 563 ) DATE
)
)
On appeal from the decision of the
Department of Veterans Affairs Regional Office in St. Louis,
Missouri
THE ISSUE
Whether new and material evidence has been received to
reopen a claim of entitlement to service connection for
menometrorrhagia.
ATTORNEY FOR THE BOARD
Nadine W. Benjamin, Counsel
INTRODUCTION
The veteran served on active duty from November 1974 to
November 1977. This matter comes to the Board of Veterans'
Appeals (Board) on appeal from a
September 1992 rating decision by the Department of Veterans
Affairs (VA) Regional Office (RO) in St. Louis, Missouri.
In August 1981, the RO denied service connection for a
gynecological condition, finding that menometrorrhagia was a
constitutional and developmental abnormality and not a
disability under VA law for which compensation is payable.
The veteran was notified of this decision in August 1981,
and she did not timely appeal. The decision therefore
became final. The veteran now seeks to reopen her claim and
this appeal ensued.
REMAND
The veteran seeks to reopen her claim of entitlement to
service connection for menometrorrhagia. The record shows
that during service she was treated on numerous occasions
for gynecological complaints including cramping, heavy
bleeding and abdominal pain. Various diagnoses are of
record, including menometrorrhagia, dysmenorrhea, pelvic
inflammatory disease, possible right ovarian cyst, possible
ectopic pregnancy, breakthrough bleeding, ovarian cyst and
anovulation. In July 1977, she underwent a dilation and
curettage.
VA records show that the veteran was hospitalized in
November 1978 and underwent a dilation and curettage for
vaginal bleeding. In July 1980, menometrorrhagia and small
fibroid tumors were noted after the veteran complained of
continuous bleeding during her menstrual period. In
September 1980, it was noted that the veteran was being
followed in the clinic for menometrorrhagia.
In a May 1992 statement, the veteran reported that she had
received treatment at several facilities, including the
following: the VA Medical Center in New York, New York;
Darnell Army Hospital; Methodist Hospital; the VA facility
in San Bernadino; and the VA facility in St. Louis,
Missouri. Complete information concerning this treatment
was not provided.
The veteran was examined by VA in June 1992. At that time,
the examiner referred to a gynecology examination which had
been performed on the veteran in May 1992. A report of that
examination, if performed, is not of record. The veteran
gave a history of treatment for gynecological problems since
1975. Left ovarian cyst was among the diagnoses.
In view of the VA's statutory duty to assist veterans in the
development of all pertinent facts involving their claims,
the Board finds it necessary to REMAND this matter to the RO
for the completion of the following actions:
1. The RO should correspond with the veteran and request a
complete list of the names, addresses and dates of treatment
concerning any care received before or since service for her
gynecological problems from any health care provider, either
VA or non-VA. The RO should then obtain photocopies of all
available records for inclusion in the claims folder. All
attempts to secure information and/or medical records should
be documented in the claims folder.
2. The dispositive issue on appeal concerns the etiology of
the appellant's gynecological abnormalities and menstrual
irregularities relative to her treatment in service.
Therefore, the veteran should be afforded an examination by
a board certified gynecologist, if available, for the
purpose of determining the nature and origin of the
veteran's gynecological difficulties. This examination
should include any necessary tests, and the claims folder in
its entirety, as well as a copy of this remand, must be
provided to and reviewed by the examiner prior to conducting
this study. In addition to reporting any current clinical
findings, the examiner is requested to offer an opinion as
to whether it is at least as likely as not that any current
disability is related to the veteran's inservice treatment
and whether current gynecological disability is acquired or
developmental. All opinions and conclusions must be
supported by a complete rationale.
3. Following the completion of the foregoing the RO should
review the claims file to ensure that all of the foregoing
development has been completed in full, and that all
requested opinions have been provided. If the examination
report is deficient in any manner it must be returned for
appropriate action.
4. Then the RO should take any other necessary development,
and readjudicate the issue on appeal. Should new and
material evidence be found to exist, the claim should be
reopened and reveiwed on a de novo basis.
If the action taken remains adverse to the veteran in any
way, she should be provided a Supplemental Statement of the
Case. She should then be afforded a reasonable period of
time in which to respond. The case should then be returned
to the Board for further appellate consideration. In taking
this action, the Board implies no conclusion, either legal
or factual, as to any final outcome warranted. The
appellant need take no action until otherwise notified by
the RO
ROBERT E. SULLIVAN
Member, Board of Veterans' Appeals
(CONTINUED ON NEXT PAGE)
The Board of Veterans' Appeals Administrative Procedures
Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740,
___ (1994), permits a proceeding instituted before the Board
to be assigned to an individual member of the Board for a
determination. This proceeding has been assigned to an
individual member of the Board.
Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United
States Court of Veterans Appeals. This remand is in the
nature of a preliminary order and does not constitute a
decision of the Board on the merits of your appeal. 38
C.F.R. § 20.1100(b) (1994).
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